Pregnancy Weeks 33-37 - Page 9

Birth planning

As your due date nears, you may be thinking about labor and the birth of your baby. This is a special time, and you will want to make the experience memorable. One of the ways to help communicate your desires and expectations about your birth experience is through a birth plan. This is not an order sheet to be checked off, but a tool to let your health care providers know the things that are important to you during labor and birth. By sharing these in advance, you will also have the opportunity to ask questions about various options. Just as every labor and birth is different, no one birth plan fits all. As you think about the choices and discuss what is best for your own pregnancy, remember to be flexible. Things can change quickly and plans may need to be revised.

Points to consider as you plan for labor and birth include the following:

Who do you want to be with you during this experience? This might include your spouse, parent, friend, or a professional doula (a woman trained to provide emotional, physical, and educational support to women and their families during childbirth and postpartum).

What procedures are you comfortable with? These might include an IV, ability to eat and drink in early labor, continuous fetal monitoring, and the ability to change position and walk around. Ask which may be medically necessary for your birth.

Do you plan to take pictures or videotape the experience?

How do you plan to manage discomforts? This might include relaxation, breathing techniques, and tub or shower access.

What type of pharmacologic pain management is acceptable to you? This might include pain medications or epidural anesthesia.

What are your preferences about an episiotomy?

What birthing position do you want to use? This might include sitting, squatting, or side-lying.

Do you want your support person to be able to cut the umbilical cord?

For a Cesarean birth, do you want your support person with you?

Do you want to have your newborn placed against your skin and the opportunity to breastfeed immediately after birth?

Do you want your newborn to stay with you for the initial procedures such as eye medication, vitamin K injection, and first bath?

Are there any special cultural or religious traditions you wish to keep?

What are Braxton-Hicks contractions?

Many women have periods of relatively brief, painless uterine contractions called Braxton-Hicks contractions. These contractions are sometimes thought of as practice contractions, helping the cervix become ready for labor. You may have them irregularly and they may vary in length and intensity in the last part of your pregnancy. As you near your due date, these "false labor" contractions can become painful.

While Braxton-Hicks contractions are a normal part of pregnancy for many women, it's important to know the difference between this type of contraction and the real thing. Here are some clues:

Braxton-Hicks contractions have no regular pattern. True labor contractions may start out irregular in length and intensity, but become regular and stronger over time.

Braxton-Hicks contractions are usually relieved by a change in your activity. If you are lying down and having contractions, take a short walk. If you are active, and they occur, lie down and rest, or take a warm bath. Drinking a big glass of water may also help. True labor contractions will continue to strengthen and become more frequent no matter what you do.

Braxton-Hicks contractions are usually the only symptom. With true labor contractions, you may have other symptoms, including blood-tinged discharge or water from your vagina, intestinal upset, persistent lower back pain, or more than six contractions in one hour.

Always contact your health care provider if your contractions continue more than one hour, and especially if you are less than 37 weeks pregnant.